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Angiotensin Converting Enzyme Inhibition in Children With Mitral Regurgitation (AceiMR)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00113698
Recruitment Status : Terminated (lower than expected enrollment)
First Posted : June 10, 2005
Last Update Posted : March 13, 2014
National Heart, Lung, and Blood Institute (NHLBI)
Pediatric Heart Network
Information provided by (Responsible Party):
Lois LuAnn Minich, University of Utah

Brief Summary:
This study will evaluate the efficacy and safety of angiotensin converting enzyme inhibition (ACE-I) therapy for the treatment of mitral regurgitation (MR).

Condition or disease Intervention/treatment Phase
Heart Defects, Congenital Heart Septal Defects, Ventricular Heart Failure, Congestive Drug: Enalapril Other: Placebo Phase 3

Detailed Description:


MR causes volume overload and hemodynamic burden on the left ventricle. Initial compensatory mechanisms may fail, leading to increased severity. Patients who have had repair of an atrioventricular septal defect (AVSD) are selected for this study as they have a relatively high incidence of moderate MR and their regurgitant orifice is mobile and dynamic, contributing to the likelihood that they might respond to medical therapy.


This is a randomized, double-blind, placebo-controlled trial of ACE-I therapy in children less than 18 years of age with at least moderate MR who are at least 6 months postoperative from repair of an AVSD. A non-randomized Observational Phase enrolled 181 children who were less than 6 months postoperative from repair of an AVSD, who were then evaluated at 6 months for trial eligibility.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 5 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Official Title: Trial of ACE Inhibition in Children With Mitral Regurgitation After Repair of AVSD
Study Start Date : December 2004
Actual Primary Completion Date : November 2005
Actual Study Completion Date : January 2006

Arm Intervention/treatment
Placebo Comparator: 1 Other: Placebo
Placebo An inert preparation with similar appearance and taste to the drug

Active Comparator: 2
Ace inhibition (enalapril)
Drug: Enalapril
Up-titration period is to reach the highest tolerated dose up to a maximum of 0.4 mg/kg/day

Primary Outcome Measures :
  1. Comparison of the effect of ACE-I therapy with that of placebo on left ventricular size [ Time Frame: Measured after six months of therapy ]

Secondary Outcome Measures :
  1. Comparison of the effect of ACE-I therapy with placebo on MR severity, left ventricular geometry, hemodynamics, and signs and symptoms of congestive heart failure [ Time Frame: 6 months on study drug ]
  2. Evaluation of the early natural history of MR in the six months after repair of an AVSD [ Time Frame: 6 months on study drug ]
  3. Comparison of the incidence of adverse events occurring in subjects treated with ACE-I therapy to that in subjects receiving placebo (measured after six months of therapy) [ Time Frame: 6 months on safety drug ]

Information from the National Library of Medicine

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Ages Eligible for Study:   up to 18 Years   (Child, Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Children less than 18 years of age and at least 6 months post AVSD repair or reoperation
  • At least moderate MR
  • Asymptomatic or minimally symptomatic, defined by Ross Heart Failure Class I or II
  • Atrioventricular synchrony (paced or intrinsic)

Exclusion Criteria:

  • Tetrology of Fallot, total or partial anomalous venous connection
  • More than trivial MS or outflow obstruction
  • Other sources of LV volume overload
  • Hypertrophic obstructive cardiomyopathy
  • Significant residual coarctation

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00113698

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United States, Massachusetts
Children's Hospital Boston
Boston, Massachusetts, United States, 02115
United States, New York
Columbia College of Physicians and Surgeons
New York, New York, United States, 10032
United States, North Carolina
Duke University Medical Center
Durham, North Carolina, United States, 27710
United States, Pennsylvania
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States, 19104
United States, South Carolina
Medical University of South Carolina
Charleston, South Carolina, United States, 29425
United States, Utah
Primary Children's Hospital
Salt Lake City, Utah, United States, 84132
Canada, Ontario
Hospital for Sick Children
Toronto, Ontario, Canada, M5G 1X8
Sponsors and Collaborators
University of Utah
National Heart, Lung, and Blood Institute (NHLBI)
Pediatric Heart Network
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Principal Investigator: LuAnn Minich, MD Primary Children's Hospital, Salt Lake City, UT
Publications automatically indexed to this study by Identifier (NCT Number):
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Responsible Party: Lois LuAnn Minich, Primary Investigator, University of Utah Identifier: NCT00113698    
Other Study ID Numbers: 185
U01HL068269 ( U.S. NIH Grant/Contract )
U01HL068270 ( U.S. NIH Grant/Contract )
U01HL068279 ( U.S. NIH Grant/Contract )
U01HL068281 ( U.S. NIH Grant/Contract )
U01HL068285 ( U.S. NIH Grant/Contract )
U01HL068288 ( U.S. NIH Grant/Contract )
U01HL068290 ( U.S. NIH Grant/Contract )
U01HL068292 ( U.S. NIH Grant/Contract )
First Posted: June 10, 2005    Key Record Dates
Last Update Posted: March 13, 2014
Last Verified: March 2014
Additional relevant MeSH terms:
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Heart Failure
Mitral Valve Insufficiency
Heart Septal Defects
Heart Defects, Congenital
Heart Septal Defects, Ventricular
Congenital Abnormalities
Heart Diseases
Cardiovascular Diseases
Heart Valve Diseases
Cardiovascular Abnormalities
Angiotensin-Converting Enzyme Inhibitors
Protease Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Antihypertensive Agents